Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance

Abstract

Summary Objectives Diarrhea is a leading cause of morbidity and mortality for children, although sparse data is available on the etiology of diarrhea in China. This study was conducted to determine main causes that underlie childhood diarrhea and related diseases. Method Surveillance data for diarrhea was collected from 213 participating hospitals between 2009 and 2013. These stool specimens, from children aged 0e59 months, were then analyzed for a panel of etiological agents consisting of 5 viruses, 8 bacteria and 3 protozoa. The proportion of children who tested positive for each pathogen was calculated and seasonal patterns for major organisms were determined. Results Pathogens were identified in 44.6% of the 32,189 samples from children with diarrhea. The most commonly detected pathogens were rotavirus (29.7% of cases), norovirus (11.8%), Diarrheagenic Escherichia coli (DEC; 5.0%), adenovirus (4.8%), non-typhoidal Salmonella (NTS; 4.3%), and Shigella spp. (3.6%). A strong seasonal pattern was observed for these organisms, including rotavirus (winter), norovirus (autumn), and DEC, NTS, and Shigella (summer). Conclusion: A wide range of enteropathogens were detected in this five-year surveillance study; rotavirus and norovirus were most common among children under the age five. These findings should serve as robust evidence for public health entities when planning and developing national intervention programs in China.

Epidemiology and Genetic Diversity of Rotavirus in Kunming, China, in 2015

“…In 7 samples the P genotype was identified but the G genotype was still not distinguished, and in 9 RVA specimens the G genotype was defined but P genotype remained negative; 333 (95.4%) samples were identified to have both G and P genotypes. G9P(8) strains had the highest score (58.2%), followed by: G3P(8) (14.9%); G1P(8) (6.9%); G3G1P(8) (5.2%); G3P(4), G8P(9), and G9P(4) (1.1%); G1P(4), G2P(8), G4P (8), and G1G2P(4) (0.9%); G2P(6), G3P(9), G4P(6), G9P(6), and G1G9P(8) (0.6%); and G4P(4) and G2P(4)P(8) (0.3%) ( Table 2). These data suggested that G9P(8) strains are prevalent among children infected with RVA in Kunming, China.…”

“…Molecular epidemiological studies have distinguished 27 G genotypes and 35 P genotypes. Of major worldwide epidemiological importance are the genotypes G1P(8), G2P(4), G3P(8), G4P (8), and G9P (8) and, to a lesser extent, G12P(8) [7].…”

“…The prevalence of RVA in children with gastroenteritis is 29.7% in China, and it is the most commonly identified enteral causative agent in acute gastroenteritis patients [8]. At present, data of RVA-related diarrhea is very limited in developing region such Yunnan Province, China.…”

Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors

“…Approximately, 80% of the total diarrhoea incidence relates to children younger than two years of age (Walker et al, 2013). After this age, the rate of illness falls as the first infections induce a certain level of immunity, which protects against following incidences (Yu et al, 2015). Gender is also important, because of differences in immune system functioning between girls and boys, and because girls have been shown to have lower morbidity and mortality rates than boys (Muenchhoff & Goulder, 2014).…”

Norovirus, the Next Target for Vaccine Development in China

“…For this purpose, the articles, which children under the age five [17] . Age group of 6-23 month-old children and that of people over 45 years old were found with the highest positive percentage, 13.7% and 12.4% respectively.…”